By CHRIS SILVA

In the five years since Michigan legalized adult-use cannabis, the plant and its effects — positive and negative — have received increasing attention and mainstream acceptance.

As cannabis has emerged from the shadows, more products have entered the market, and with that increase, negative interactions are now being documented for the first time, making the statistics appear overwhelming. One of the most concerning trends is the rise in youth hospital visits due to cannabis intoxication since legalization. Additionally, a new and alarming health issue, cannabis hyperemesis syndrome, has gained attention as cannabis use becomes more widespread, not only in Michigan but across the United States.

Youth hospital visits

From 2020 to 2022, the Michigan Poison and Drug Information Center had 801 occurrences of cannabis ingestion toxicity among children under 5. This marks a nearly 75% increase in unintentional youth cannabis ingestion, while the nationwide increase during the same period was around 60%.

This uptick in unintentional cannabis use is only one aspect of the larger issue. Across Michigan, school administrators are engaged in a battle to keep vapes — both THC and nicotine — from infiltrating school bathrooms and locker rooms.

Despite these challenges, many advocates point to the fact that Michigan’s cannabis market is one of the most tightly regulated in the nation. The state’s regulations on packaging and marketing of edibles and other THC products aim to reduce confusion with commercially available candies. Since the introduction of both medical and recreational cannabis programs, Michigan has enforced stringent rules, including clear labeling and dosage restrictions.

The Cannabis Regulatory Agency has implemented specific guidelines to ensure products are not appealing to children. These include prohibiting cartoon characters and the word “candy” and ensuring that products are sold in opaque, child-resistant packaging.

Cannabis hyperemesis syndrome

Cannabis hyperemesis syndrome, or CHS, is a recently recognized condition linked to frequent cannabis use. It causes severe abdominal cramps, nausea and vomiting and typically affects individuals who use cannabis daily or weekly. CHS’ underlying causes are still not well understood, and there is limited research on the syndrome. While there are few definitive treatments, many who suffer from CHS report finding relief from hot showers during episodes of nausea and cramping. The only known way to permanently stop CHS is complete cessation of cannabis use.

There has been ongoing debate among advocates and industry members about CHS’ prevalence. Some theorize that further research may uncover a contributing nutrient or additive used in cultivation. Given that cannabis use was largely undocumented due to its illegal status for many years, it’s unclear whether CHS is truly on the rise or if it is simply being reported more frequently now that cannabis is legal.

‘Legal weed’

One of the more troubling and confusing aspects of the cannabis landscape today is the increasing prevalence of unregulated “intoxicating hemp” products. These items, often sold at gas stations and head shops, are not subject to the same regulations as cannabis products in the legal market. Many products mimic popular candy brands or employ prohibited imagery, such as cartoon characters, to appeal to younger audiences. Unfortunately, many retailers in gas stations and party stores sell these products to minors, which adds to the public health concerns.

The lack of oversight in this sector allows for the sale of edibles that not only resemble candy but are also often much stronger than products available on the legal market. Additionally, the use of CBD conversion oil, a controversial method for turning legal hemp into “legal” delta-9 THC, is raising alarm. The safety of this conversion process remains questionable, and many industry advocates are concerned about the risks associated with these unregulated products.

Michigan’s legal cannabis market has garnered widespread mainstream acceptance. It has also created new challenges. Increased youth intoxication, the emergence of cannabis hyperemesis syndrome, and the growth of unregulated hemp products underscore the need for continued vigilance, research and regulatory oversight to ensure public health and safety.